P16-positive esophageal squamous cell cancer as an interdisciplinary challenge: A case report

Introduction:

P16-positive squamous cell carcinomas were first described in the anogenital region. Since the publication by Hayes in 2012, p16 association has also been characterized in oropharynx carcinomas. These regions have to therefore be initially considered in primary tumor detection in cases of p16-positive squamous cell cancer metastasis. Despite this trend, p16-positive primary tumors have also been found in other areas of the body.

Methods:

We report a case of a 51-year-old female patient with an abdominal metastasis of a p16-positive squamous cell cancer.

Results:

Initially a large tumor in the upper abdomen infiltrating the liver, pancreas and adjacent to the stomach, the portal vein, the splenic artery and surrounding the common hepatic artery was found on a CT scan. Furthermore, lymph node metastasis was detected in retroperitoneal and mediastinal region as well as in the liver hilum. After performing a FDG-PET-CT scan the primary tumor was suspected in the esophagus and a carcinoma of the anogenital region was ruled out. During an esophagoscopy a p16-positive esophageal squamous cell cancer was detected.

Conclusions:

In our interdisciplinary tumor board conference the possibility of contact metastasis of an oropharynx carcinoma in the esophagus was considered. Present literature demonstrates that 10 to 22% of esophageal squamous cell carcinomas are p16-positive. Further primary tumor manifestations have been known to be present in the skin and the lungs and should be considered during primary tumor detection.

Publication History

Publication Date:
23 April 2019 (online)